Why don't nurses listen to cna's

Trishalishus, PhD, CNS · Jul 18, 2009

One comes across this kind of elitist sheet often. I think it's a form of kicking the next person further down the power chain. That is, I think there are a lot of low-self-esteem people out there in nursing (and elsewhere) who take out their inadequacies on others. Did the other nurses in the same joint take you seriously? I bet they did. Did you ever get the impression that people in your profession didn't like working with you? If not - and I suspect not (from your caring attitude and level of concern) - then give this weak,sad,pathetic nurse no more power over you (to torment you like this via your memories).

People like her either don't last because their attitude is so ugly they're doomed to fail; or they're getting ready to retire and they're burned out and too tired to engage emotionally any more (let alone do the hard work). The good nurses DO listen to care attendants - with their ears flapping and a pen and paper in their hand - or they start moving towards your patient before you've even finished speaking. They also consult WITH care attendants, and when they find one who really cares, they like to pass on tips and teach you how to do a better job and give you chances to help them do some of their RN-licensed work under their supervision so you can grow.

As for the poor feller who died... I had a pt with a similar problem when I was doing personal care work. I nagged and nagged and the (lazy sheetful) nurse on duty ignored me for days. In the end I told his wife to complain to management. The very same day (imagine that) they drained 1500mls of dark tea-coloured urine from his bladder in less than 20minutes after inserting a new SPC. He had been in agony for days. I was just as angry as you and got precisely nowhere like you. I think all you can do in future is make sure you have a reputation as a good team player who is also a strong patient advocate - and then complain to management or go outside the system if you feel strongly enough about something. You have to go to management first, though - because you owe some loyalty to your employer as a member of the team. Afterwards, I personally think you have a moral duty to yourself to follow through on your beliefs - and an ethical duty to look after your patient.

I'm sorry this still troubles you so much. I don't know if it helps, but I have lots of stories like this about incompetent nurses - and I am using the rage I feel about their abuse of power as fuel to help me drive myself to become the best nurse I can be. Try and find a way to take something positive from this experience. Remembering your patient with sadness is an honour to his humanity - and his experience teaches you something for next time. Letting the pondscum of the world distress you is a dishonour to yourself.

Good luck and best wishes

SuesquatchRN, BSN, RN · Jul 18, 2009

I always, always, always listen to the aides.

I had an aide come to me one day and tell me that a resident's leg looked wrong. Well, she knew as well as I did that "that ain't right" and it wasn't. He was sent straight to the hospital with a massive phlebitis.

I sometimes ran into this as an LPN from the RNs. Rise above it and keep up the good work.

:)

HeartsOpenWide, RN · Jul 18, 2009

Some nurses just have to get off their high horses. I am a new nurse but when I was in nursing school I once asked an aid to monitor me give a IV push narcotic mistaking him for a RN because he really knew his stuff. Of course he corrected me and said he couldn't because he was not an RN but and aid. He should go back to nursing school. There are many people on here that have college degrees in other fields but work as nurses aids. I can see with the high turn around rate and the high rate of "get any one that walks" to be an aid attitude; especially in TLC, the nurse might not trust all aids, but she should have at least investigated what you were telling her and take your experience into consideration.

KimberlyRN89, BSN, RN · Jul 18, 2009

This reminds me so much of a story a coworker told me. In her story though, the nurse got fired. I think you will make a great nurse & I wish you the best of luck :)

nurse12b · Jul 19, 2009

Thank you for all of your comments. To the nurses that trust in your cna's thank you for not just treating them as a butt changer. I personally believe that RN's should be a cna before becomming a nurse, I think it gives you a differant perspective on pt care. I know I am greatful that I have the cna experience as I go on to be a nurse. I will never forget where I came from.

ShannonRN2010, BSN, RN · Jul 19, 2009

Actually a good nurse will ALWAYS listen to the Aides because they have more hands on time with the pt. or residents than we do.

I viewed my aides as my eyes and ears, when it came to change in status of my residents.

You get some nurses that...really think that they are the shizznit because they have more education, but rule one of nursing, trust your aides!

Butterfliesnroses · Jul 20, 2009

I've had nurses not listen to me as well. I remember one time a resident was dying and showing s/s that he was in pain so I told the resident that I thought the resident was in pain. She said she was the nurse and knew when someone was in pain and I was just an aide. That made me feel really low. I've been made to feel like scum! I've told my fellow CNAs to please slap me across the face if I ever begin to act like I'm above them. I'm going to nursing school.

I've also had nurses really listen to what I have to say and investigate what is happening. Those nurses are the best! I'd trust them with my life. I remember one time I was talking to a resident and the nurse was right there and I said I'm just an aide...she corrected me and said no you are aide, a wonderful aide...you aren't JUST an aide. She told me how important my role as an aide was to the care of the residents and she's so right. I think being an aide is the most humbling job.

NurseCubanitaRN2b, BSN, RN · Jul 21, 2009

You will get it on both ends. You will have nurses who weren't CNA's who are the most compassionate towards their aides and patients because they see how hard their aides work and they really care about their job as a nurse. They also enjoy helping other people On the other hand you will see other nurses who used to be CNA's forget that they were once aides. They like to be very bossy, and they sure love delegating to the max and they love to throw their education around. I even had a LVN tell me, and I'm paraphrasing "Well when you get educated and you become a nurse you will understand. You're just the CNA". I looked at her and I said "When I get educated? I already hold a Bachelors degree in another field, and I'm already educated. I just decided I wanted to go back to nursing. So I am already educated, just in another field." She was shocked, and couldn't believe I was educated with a Bachelors degree.

Anyway, I wanted to point out something about the original posters post, and I hope nobody takes this the wrong way but this is what I'm seeing and it also comes from experience as an aide. What the original poster said she said to the nurse "I think his kidneys are failing". I as an aide would never say something like that to a nurse. I would just report to the nurse "the patient told me he hasn't urinated in 3 days and he says that his left side hurts". Leave it at that. Although, his kidneys might be failing, that's not something for you to mention. Nurses look for aides to do and say things that may lead the aide to jump out of their scope of practice, then they can report them to the DON or the Head Nurse. I can tell by this poster that she's a very compassionate person and all she wanted to do was help the patient. But the comment could have also made the nurse upset. The nurse could have been thinking "who is this aide telling me that she thinks the patients kidneys are failing" Also by the original poster telling the nurse "I think you should have the patient sent to the hospital because he hasn't urinated in 3 days" was a big mistake on the aides part. Again, she was acting out of concern for the patient. The original poster is basically telling the nurse how to do her job. The nurse snaps back and tells her "you're just an aide". The nurse got offended that a CNA would tell her how to do her job. Since I don't know the whole story regarding this patient, I really can't comment on anything except what is being told. Most facilities wouldn't send a patient with a distended bladder to the hospital. Depending on where you work, they might have an order for a straight cath. Since the aide isn't in communication with the doctor, maybe the doctor has already been contacted regarding the distended bladder and the nurse was waiting to get an order to straight cath him. Some facilities have standing orders and others don't. Maybe the doctor is a real jerk and the nurses have a hard time dealing with himm, you as a CNA wont know that unless the nurse tells you. Since it seems that the nurse really didn't communicate with the original poster about the patient and his condition it's not safe to assume anything here. What I see here is lack of communication between the aide and the nurse. If there was problems going on here between the doctor, the patient, and the nurse, the aide wont know that. As I said I'm not excusing the nurse for her actions. I think the nurse should have explained to the original poster the reason why she did what she did. She doesn't have to go into detail because in the end, she doesn't report to the aide, the aide reports to the nurse. But the nurse could have given the aide a rundown on the situation at hand, and why it seems as if nothing is being done. When you don't communicate with your other health care team members it leads to situations like this. So please nurse12b please don't feel guilty. It probably was something that was already in the making and you just got caught up in it. It was nothing that you did or didn't do. You did the right thing by reporting it to your nurse. You did your job!

Since the patient died of kidney failure, most likely it was something that was bound to happen. Was the patient already going through renal failure? Was he a dialysis patient? Was he on a renal diet already? What type of medication was he on? The type of medication that he is on is going to tell you the patient dx. You can distinguish what the person has by the meds alone.

Since you said you're going through nursing school you will see that things totally change once you become a nurse. I agree with you, you will always listen to your aides. You have the right attitude because your CNA can either make your job easy for you, or they can make it miserable for you. I too will always listen to my aides and what I would have done if I were your nurse I would have explained to you why I can't do anything but give him a pill (you did say that's what the nurse did right?). That will make you as the aide understand why I did things the way I did. I also would have pulled you to the side and said to you in nice way basically not to tell me the nurse how to do my job, because by doing that you're overstepping your boundaries. But then again it wouldn't have gotten to that point because you would have understood the situation a bit better. If nurses and aides can just communicate with each other it would make things so much easier. I worked with an aide who would basically read the patients chart, and would tell the nurses which meds to order for the patient. She would literally tell the patients what pain medication they could have and to bombard the nurses with certain medications, and not to take certain ones because they will make them throw up etc etc. She would do a lot of patient education and the patients would question the nurses on everything because this aide was overstepping her boundaries. This is the type of aide you DON'T WANT TO BE. My advise to new aides is basically 1. Just report to the nurse what the patient tells you 2. Don't offer any suggestions unless asked and 3. Never tell a nurse how to do her job. That will only complicate things between you and your nurse. 4. Always communicate with your nurse. Now my adivce to nurses 1. Always listen to your aides, they are your eyes and ears. 2. Explain to your aide why you do things the way you do. 3. Thank your aides at the end of the day, they worked hard to make your day easier, they deserve it! 4. Always communicate with your aides.

NurseCubanitaRN2b, BSN, RN · Jul 21, 2009

Thank you for all of your comments. To the nurses that trust in your cna's thank you for not just treating them as a butt changer. I personally believe that RN's should be a cna before becomming a nurse, I think it gives you a differant perspective on pt care. I know I am greatful that I have the cna experience as I go on to be a nurse. I will never forget where I came from.

I do agree with you! I believe a nursing student should be required to take the CNA course and gain experience as an aide before being admitted into the nursing program. You're going to do basic fundamentals anyway, might as well take the CNA and get yourself prepared for nursing school. If you have other experience as a Phlebotomist, or EKG Tech, that's good experience too. I'm so thankful that I became a CNA before I went to nursing school. It made my job as a student nurse so much easier. I too wont forget where I came from and I will encourage my aides to go on and become a nurse. :nurse:

Butterfliesnroses · Jul 21, 2009

A good point is brought up. It's never okay for an aide to diagnose. As an aide we can't only report signs/symptoms the resident is experiencing. I've had aides document that so and so has a UTI b/c they are urinating frequently, even though a urine dip wasn't done. Said aide just documented that. Appropriate charting would be that resident is urinating frequently. And all that should be reported to the nurse is that resident is urinating frequently. The nurses I know, most of them would suggest getting a hat and getting a sample. This same aide demands nurses send residents to the hospital and nothing makes a nurse more mad than an aide saying that. At least in the settings I work in. The nurse then brings out her claws, which may have happened.

Virgo_RN, BSN, RN · Jul 21, 2009

A good point is brought up. It's never okay for an aide to diagnose.

I had an aide fail to notify my that my patient only had 100mL out in six hours. When I asked her about it, she admitted that she was aware and her excuse was "Well, he has that UTI...."

I got a UA ordered from the doc, which was negative for a UTI, and I pushed PO fluids and he voided an additional 750mL by the end of my shift.

There have been many instances where all I can do at the moment is say "OK", but the next time I go into the patient's room, I am assessing what the aide told me and taking appropriate action. The aides do not see this part, and can have the mistaken impression that I didn't listen to them or that I did nothing.

Sometimes what they tell me is consistent with the patient's diagnosis, and is an expected finding, so no action is warranted. But the CNA would not know that, and it can be dangerous to explain it all to some CNAs, because then they might fail to notify me of things that I do need to know, as in the above example.

Basically, I want to know of all abnormals, whether I decide to do anything about it or not. My response might be "OK", but that doesn't mean I'm not doing anything about it. :nurse: